(R. 067/061/0765/31/06)

Cabinet for Health and Family Services

Office of Contract Oversight

Department for Community Based Services

Vickie Cravens, Contract Specialist

Division of Contract Development Services

275 East Main Street, 4 E-E

Frankfort, KY 40621

Telephone: 502 / 564-6746 ext. 3381

Fax: 502 / 564-2467

E-mail:

Table of Contents

Section 1─Administrative Overview

1.00─Purpose

1.01─Issuing Office

1.02─Facility/Location and License Number

1.03─Restrictions on Communications

1.04─Terminology

1.05─Organization

Section 2─Scope of Work

2.00─Scope of Work

2.01─Reporting/Monitoring Requirements

2.02─Outcomes

2.03─CHFS/Agency Responsibilities

2.04─Total Amount of Contract

Section 3─Terms and Conditions

3.00─Beginning of Work

3.01─Contract Components and Order of Precedence

3.02─Term of Contract and Renewal Options

3.03─Changes and Modifications to the Contract

3.04─Changes in Scope

3.05─Cancellation

3.06─Contract Conformance

3.07─Notices

3.08─Payment

3.09─Expenses

3.10─Social Security

Section 4─CHFS Standard Terms and Conditions of Memorandum of Agreements

4.00─The Contract

4.01─Attachment(s)

4.02─Effective Date of Contract and Earliest Date of Payment

4.03─Extension Periods and Amendments to Contract

4.04─Funding

4.05─Assignment

4.06─Bankruptcy

4.07─Contractor Cooperation in Related Efforts

4.08─Notice

4.09─Headings

4.10─Severability

4.11─Indemnification

4.12─Sovereign Immunity

4.13─Force Majeure

4.14─Obligation of Good Faith

4.15─Code of Ethics

4.16─Influence on Purchasing and Other Business Transactions

4.17─Notices and Pamphlets

4.18─Service Delivery Requirements

4.19─Roles and Responsibilities for Proposed and Existing Staff

4.20─Total Amount of Funds and Budget Revisions

4.21─Subcontractors

4.22─Travel and Travel Hourly Rate

4.23─Responsibility for Subcontractor Contract Requirements

4.24─Subcontractor Monitoring Requirements

4.25─Cost Principles, Requirements and Limitations

4.26─Requirements and Limitations on Indirect or Administrative Cost Requirements

4.27─Financial Record Retention

4.28─Access to Records, Books, and Documents

4.29─Audit Requirements

4.30─Response/Compliance with Audit Findings

4.31─Maintenance of Insurance

4.32─Research Project Approval and Institutional Review Board Requirements

4.33─Scientific Misconduct

4.34─Intellectual Property

4.35─Provisions for Termination

4.36─Turnover Assistance

4.37─Remedies for Breach

4.38─Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion, Lower Tier Covered Transactions

4.39─Licensure, Certification, and Registration

4.40─Permits, Licenses, Taxes and Commonwealth Registration

4.41─Conflict of Interest Laws and Principles

4.42─Campaign Finance (See Exhibit B)

4.43─Legal Proceedings

4.44─Certification of Lobbying

4.45─Discrimination Prohibited (Because of Race, Religion, Color, National Origin, Sex, Age, or Disability)

4.46─Minority Recruitment, Hiring and Reporting Requirements

4.47─Violation of Tax and Employment Laws (See Exhibit A)

4.48─Certification Regarding Drug Free Workplace

4.49─Confidential Information

4.50─Confidentiality, Confidentiality Agreements and Limitations on Information and Data Use

4.51─HIPAA Confidentiality Compliance

4.52─Governing Law and Regulations

Exhibits─Procurement Requirements

Exhibit A─Sworn Statement Regarding Violations of Kentucky Revised Statutes

Exhibit B─Campaign Finance Law Compliance

Cost/Budget Form

Section 1─Administrative Overview

1.00─Purpose and Background

The Cabinet for Health and Family Services (CHFS), pursuant to Kentucky Revised Statutes, Chapters 600 - 645, is responsible for the provision of services to children committed to the Cabinet. The Cabinet seeks qualified contractual assistance to provide residential care, foster care, emergency shelter and therapeutic care to children and youth that are committed to the Cabinet. Committed children will be maintained and treated in a residential, group home or a foster home setting for a limited time so that the child may be safely returned home, or placed in a permanent adoptive home or in another less restrictive setting as soon as possible. These services may include, but shall not be limited to Child Placing and Child Caring Services.

KRS 605.090 provides that any child committed to the Cabinet may at any time during the period of commitment be placed in an approved facility of a licensed private child care organization willing to receive the child, upon such conditions as the Cabinet may prescribe.

The Cabinet has under its care certain children for whom specialized services and/or residential care are needed.

The Cabinet has entered into a Performance Improvement Plan with the Administration for Children and Families to improve safety, permanency and well-being outcomes for the families and children of the Commonwealth of Kentucky served by the Cabinet.

It is in the interests of the Commonwealth of Kentucky for the Cabinet to provide statewide leadership in collaboration with the Private Child Caring and Child Placing Agencies to improve safety, permanency, and well-being outcomes for the children and families served by the Cabinet.

The Agency has approved facilities and staff available, is a licensed child-caring and/or child-placing agency in accordance with KRS 199.640, and is willing and qualified to provide the services and/or care required for the children

1.01─ Facility/Location and License Number

Name and Address

XXXXXXX

XXXXXX

XXXXXXXXXXXXXXXX

XXXXXX

This contract shall only cover the above-mentioned services for which the Facility has been licensed. This contract shall apply to the licensed services being provided at the following locations only:

XXXXXXXXX

1.02─Issuing Office

The Commonwealth of Kentucky, Cabinet for Health and Family Services, Division of Contract Services, is issuing this Contract on behalf of the Department for Community Based Services. The Division of Contract Services is the only office authorized to change, modify, amend, alter, or clarify the specifications, terms and conditions of this Contract.

1.03─Communications

The Contract Specialist named below is the point of contact for communications concerning contract issues.

Vickie Cravens

502 / 564-6746 ext. 3381

Fax – 502 / 564-2467

E-mail –

1.04─Terminology

For the purpose of this Contract, the following terms may be used interchangeably;

a)  Contractor, Agency, Provider, or Vendor

b)  Contract Specialist or Contract Officer

c)  Commonwealth of Kentucky, Commonwealth, or State

d)  Fiscal Year will be defined as the Commonwealth fiscal year: July 1 through June 30

e) Biennium will be defined as the Commonwealth biennium: July 1 of each even numbered year through June 30 of the next numbered year

1.05─Organization

This contract is organized in the following manner:

Section 1─Administrative Overview / General information regarding the objectives of the Contract.

Section 2─Scope of Work / Description of tasks to be performed, contractor responsibilities, deliverables, performance criteria, technology standards, and system requirements.

Section 3─Terms and Conditions of the Contract / Terms and Conditions under which the Contractor shall perform this Contract.

Section 4─CHFS Standard Terms and Conditions of Personal Service Contracts

Exhibits─Procurement Requirements

Forms─OPTIONAL─A Budget may be attached depending on the structure of the cost information.

Titles of paragraphs used herein are for the purpose of facilitating ease of reference only and shall not be construed to infer a contractual construction of language.

Section 2─Scope of Work

2.00─Scope of Work

The Cabinet for Health and Family Services (CHFS), pursuant to Kentucky Revised Statutes, Chapters 600 - 645, is responsible for the provision of services to children committed to the Cabinet. The Cabinet seeks qualified contractual assistance to provide residential care, foster care, emergency shelter and therapeutic care to children and youth that are committed to the Cabinet. Committed children will be maintained and treated in a residential, group home or a foster home setting for a limited time so that the child may be safely returned home, or placed in a permanent adoptive home or in another less restrictive setting as soon as possible. These services may include, but shall not be limited to Child Placing and Child Caring Services.

Services to Families and Children:

a)  Accept selected children that are referred by the Cabinet to its Agency for services and/or care in accordance with the Agency's Application to Provide Private Child Care Services to provide the following: Foster Care and Therapeutic Foster Care Services.______Services. The Application is on file with the Cabinet for Health and Family Services and the Agency.

b)  Document the Agency's action on each referral by completing Section G. of the CLIENT INTERAGENCY PCC REFERRAL FORM THE CABINET-886, and sending it back to the Cabinet’s office that made the referral within three (3) business days for child-caring agencies and five (5) business days for child-placing agencies.

c)  Provide such child or children with a family type environment, including adequate food, shelter, clothing (except as otherwise provided by the Cabinet under this agreement), incidental expenses, affection, training, recreation, education, and opportunities for religious, spiritual, or ethical development in the faith of the child's choice, if any.

d)  Provide each committed child with a personal allowance of at least those amounts shown in AttachmentA, and document the disbursements. Personal allowances are an entitlement of the child and may not be disbursed as contingent upon the child’s behavior or taken or withheld as a means of punishment. This does not preclude reasonable restitution for intentional damage to property.

e)  Admit all clients entering its program according to the needs of the child and the capacity of the Agency to meet those needs. The child’s type of commitment will not be a factor.

f)  Prohibit the use of Corporal Punishment for children in the custody of the Cabinet as specified in 922 KAR 1:300, and 922 KAR 1:310.

g)  Agree to report to the child’s Cabinet social service worker and parent (when appropriate) within twenty-four (24) hours, or the next working day, any critical incidents. Critical incidents are defined as: 1) possession of deadly weapon; 2) serious injury requiring professional medical treatment; to another person (includes resident, staff, foster parent etc.), resulting from a conflict with a child, 3) serious injury to a child requiring professional medical treatment (includes sexual assault and excludes physical injury requiring first aid only); 4) AWOL when a child’s whereabouts are unknown resulting in notification of law enforcement; 5) suicide attempts requiring professional medical attention; 6) criminal activity by a child resulting in notification of law enforcement (does not include those acts deemed to be status offenses); and 7) a sexual acting out incident outside of developmental norms and the normal limit of functioning for the particular child (does not include chronic sexual reactive behaviors or criminal sexual activity that is reported under item 6 above).

h)  Agree to report to the Cabinet immediately the death of a child, psychiatric/medical hospital hospitalization, and allegations of child abuse/neglect. Such reports shall be made to the child's Cabinet social service worker. In situations involving reports of suspected child abuse/neglect, the Cabinet for Health and Family Services, Division for Licensing and Regulation, Office of the Inspector General shall also be notified. Allegations of child abuse/neglect shall be reported in accordance with KRS 620.030 and to the Cabinet’s Child Abuse Hotline at 1-800-752-6200.

i)  Cooperate with the Cabinet’s six-month review to determine the goals for children and length of stay. Justification for an extension for residential care beyond the time agreed to in the treatment plan shall be completed by the Treatment Team, which shall consist of Cabinet and provider staff.

j)  Work in partnership with the Cabinet concerning the care of the children including scheduled treatment planning conferences. Participate in Cabinet Family Team Meetings and/or facilitated staffing when invited with appropriate prior notice and as the Agency has staff available.

k)  Give two (2) weeks advanced notice to the Cabinet social worker prior to the discharge of a child which is unanticipated in the treatment plan, and prior to physically relocating a child to another address. Notice must be submitted in writing, with specific reasons for the relocation of the child or the unanticipated discharge and recommendations for future treatment upon discharge. This does not preclude medically necessary treatment (i.e., psychiatric hospitalization). The Agency shall maintain the child’s placement if discharge from a hospital or detention center occurs prior to the two weeks advance notice expiring. Provide all information, including a discharge plan and treatment recommendations to the social services worker and to the next placement at the time of discharge.

l)  Provide a two (2) week paid “bed hold" at the written request of the Cabinet for children furloughed from the facility or AWOL, assuring the child can return during that period of time. Paid bed holds are not applicable when an Agency transfers a child between its own programs. This may be extended at the written request of the Cabinet for two (2) additional paid weeks if medically necessary. If the absence exceeds 2 weeks (4 weeks with approved medical need), the child shall be treated as a new admission.

m)  Cooperate with the Cabinet concerning the care of the children, including the assistance of staff with scheduled treatment planning conferences to meet federal and state requirements, and in plans for individual children receiving services and/or care from the Agency.

n)  Provide the Cabinet’s social service worker information needed to coordinate plans and services to a child and a child's family (when appropriate) and to conduct required case reviews such as the Five (5) Day Case Planning Conference, Six (6) Month Case Planning Conference, Administrative Reviews, and Judicial Reviews.

o)  Return such child or children to the authorized representative of the Cabinet at any time upon request.

p)  Provide social services consistent with the child’s treatment plan to the child or children and family.

q)  Inform the Cabinet social service worker prior to any off-campus employment of any child receiving services or care under provision of this agreement and screen proposed work assignments and off-campus employment for compliance with Child Labor Laws, KRS Chapter 339.

r)  All personal clothing and any clothing allowance monies not spent shall be given to the child, the child’s social service worker, sent to the Cabinet’s social service worker, or sent to a location designated by the child’s social service worker. All personal clothing shall be provided within 7 days of the child’s discharge from the placement. Any unspent clothing allowance monies shall be provided within 14 days of the child’s discharge from the placement. A written inventory of the child’s clothing and a written accounting of the child’s clothing allowance will be made available to the child’s social service worker upon request.

s)  Maintain case records indefinitely in accordance with applicable laws and regulations. All other records shall be maintained at least six (6) years from the date of the last payment received for the agreement period, or until audited/monitored and auditing/monitoring exceptions are resolved, whichever is later.

t)  Develop and maintain a Life Book for each child receiving services or care under the provision of this agreement. Reimbursement of Life Book expenses is included in Attachment A, Rate Schedule. Provide the child’s Life Book to the Cabinet’s social worker upon discharge of the child from the Agency.

u)  The Agency agrees that Cabinet Social Service Workers conducting child abuse investigations in a non-familial Private Child Care setting have complete access to, including the right to inspect and copy, all current clinical, historical, medical and contextual information and documentation.